2022
Prognosis of hospitalized patients with cirrhosis and acute kidney disease
Wong F, Garcia‐Tsao G, Reddy KR, O'Leary JG, Kamath PS, Tandon P, Lai JC, Vargas HE, Biggins SW, Fallon MB, Thuluvath PJ, Maliakkal BJ, Subramanian R, Thacker L, Bajaj JS. Prognosis of hospitalized patients with cirrhosis and acute kidney disease. Liver International 2022, 42: 896-904. PMID: 35023264, PMCID: PMC11075740, DOI: 10.1111/liv.15154.Peer-Reviewed Original ResearchConceptsAcute kidney diseaseStage 1 AKIAKD patientsPeak ScrAKI patientsCirrhotic patientsKidney diseaseSecond infectionEnd-stage liver diseaseDecompensated cirrhotic patientsHigher hospital admissionsWorse renal dysfunctionNormal renal functionGlomerular filtration rateNorth American ConsortiumBaseline SCrRenal dysfunctionPrompt treatmentRenal functionSerum creatinineHospital admissionClinical outcomesLiver diseasePredictive factorsFiltration rate
2021
Admission Urinary and Serum Metabolites Predict Renal Outcomes in Hospitalized Patients With Cirrhosis
Bajaj JS, Garcia‐Tsao G, Reddy KR, O’Leary J, Vargas HE, Lai JC, Kamath PS, Tandon P, Subramanian RM, Thuluvath P, Fagan A, Sehrawat T, de la Rosa Rodriguez R, Thacker LR, Wong F. Admission Urinary and Serum Metabolites Predict Renal Outcomes in Hospitalized Patients With Cirrhosis. Hepatology 2021, 74: 2699-2713. PMID: 34002868, PMCID: PMC9338693, DOI: 10.1002/hep.31907.Peer-Reviewed Original ResearchConceptsAcute kidney injuryPrediction of AKIClinical variablesSerum/urineSerum metabolitesBranched-chain amino acid metabolitesLiver disease centerNorth American ConsortiumRole of serumAmino acid metabolitesAdmission urinaryAKI developmentAKI subgroupCirrhosis cohortRenal outcomesRenoprotective measuresKidney injuryAKI predictionCirrhosis severityDialysis initiationHospitalized patientsPoor prognosisUrine metabolomicsEarly initiationSpecific admission
2020
Serum Levels of Metabolites Produced by Intestinal Microbes and Lipid Moieties Independently Associated With Acute-on-Chronic Liver Failure and Death in Patients With Cirrhosis
Bajaj JS, Reddy KR, O'Leary JG, Vargas HE, Lai JC, Kamath PS, Tandon P, Wong F, Subramanian RM, Thuluvath P, Fagan A, White MB, Gavis EA, Sehrawat T, de la Rosa Rodriguez R, Thacker LR, Sikaroodi M, Garcia-Tsao G, Gillevet PM. Serum Levels of Metabolites Produced by Intestinal Microbes and Lipid Moieties Independently Associated With Acute-on-Chronic Liver Failure and Death in Patients With Cirrhosis. Gastroenterology 2020, 159: 1715-1730.e12. PMID: 32687928, PMCID: PMC7680282, DOI: 10.1053/j.gastro.2020.07.019.Peer-Reviewed Original ResearchMeSH KeywordsAcute-On-Chronic Liver FailureAdultAgedBacteriaBiomarkersDatabases, FactualFecesFemaleGastrointestinal MicrobiomeHospital MortalityHumansLipidomicsLipidsLiver CirrhosisMaleMetabolomicsMiddle AgedNorth AmericaPatient AdmissionPredictive Value of TestsPrognosisProspective StudiesRisk AssessmentRisk FactorsTime FactorsConceptsDevelopment of ACLFSerum levelsClinical parametersStool samplesSerum metabolitesEnd-stage liver diseaseWhite blood cell countSerum samplesFecal microbiomeTertiary hepatology centersChronic liver failureDay of admissionMultiple centersTime of admissionBlood cell countNorth American ConsortiumLevels of phospholipidsMetabolomic analysisHepatology centersHospital admissionLiver failureClinical featuresLiver diseaseACLFEstrogen metabolites
2019
Impact of Chronic Kidney Disease on Outcomes in Cirrhosis
Wong F, Reddy K, O’Leary J, Tandon P, Biggins SW, Garcia‐Tsao G, Maliakkal BJ, Lai JC, Fallon MB, Vargas HE, Subramanian R, Thuluvath PJ, Kamath PS, Thacker L, Bajaj JS. Impact of Chronic Kidney Disease on Outcomes in Cirrhosis. Liver Transplantation 2019, 25: 870-880. PMID: 30908855, PMCID: PMC11075743, DOI: 10.1002/lt.25454.Peer-Reviewed Original ResearchConceptsChronic kidney diseaseKidney diseasePrevalence of CKDEnd-stage liver diseaseHospital clinical courseAcute kidney injuryChild-Pugh scoreChronic liver failureHigher serum creatinineGlomerular filtration rateHigh-risk groupNorth American ConsortiumCKD groupHospital courseKidney injuryRefractory ascitesNegative patientsOverall survivalPositive patientsSerum creatinineCirrhosis etiologyClinical courseHospital admissionHospitalized patientsLiver failureTargets to improve quality of care for patients with hepatic encephalopathy: data from a multi‐centre cohort
Bajaj JS, O’Leary J, Tandon P, Wong F, Kamath PS, Biggins SW, Garcia‐Tsao G, Lai J, Fallon MB, Thuluvath PJ, Vargas HE, Maliakkal B, Subramanian RM, Thacker LR, Reddy KR. Targets to improve quality of care for patients with hepatic encephalopathy: data from a multi‐centre cohort. Alimentary Pharmacology & Therapeutics 2019, 49: 1518-1527. PMID: 31032966, PMCID: PMC6538445, DOI: 10.1111/apt.15265.Peer-Reviewed Original ResearchConceptsQuality of careAspiration pneumoniaEnd-stage Liver Disease cohortLiver disease cohortMulti-center cohortNorth American ConsortiumLiver transplantMELD scoreCirrhotic patientsDual therapyHepatic encephalopathyPneumonia developmentReadmission analysisBetter prognosisPatient cohortTherapy patientsDisease cohortLarge cohortPatientsMedicationsCohortAmerican ConsortiumTherapyReadmissionPneumoniaOutcomes After Listing for Liver Transplant in Patients With Acute‐on‐Chronic Liver Failure: The Multicenter North American Consortium for the Study of End‐Stage Liver Disease Experience
O’Leary J, Bajaj JS, Tandon P, Biggins SW, Wong F, Kamath PS, Garcia‐Tsao G, Maliakkal B, Lai J, Fallon M, Vargas HE, Thuluvath P, Subramanian R, Thacker LR, Reddy K. Outcomes After Listing for Liver Transplant in Patients With Acute‐on‐Chronic Liver Failure: The Multicenter North American Consortium for the Study of End‐Stage Liver Disease Experience. Liver Transplantation 2019, 25: 571-579. PMID: 30724010, PMCID: PMC11075742, DOI: 10.1002/lt.25426.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAcute-On-Chronic Liver FailureAdultDisease ProgressionEnd Stage Liver DiseaseFemaleHospital MortalityHospitalizationHumansLiver CirrhosisLiver TransplantationMaleMiddle AgedNorth AmericaProspective StudiesRenal DialysisSeverity of Illness IndexSurvival RateTime-to-TreatmentWaiting ListsConceptsChronic liver failureLiver transplantationNorth American ConsortiumLiver failureEnd-stage liver disease (MELD) scoreEnd-stage liver diseaseAmerican ConsortiumExtrahepatic organ failureAcute kidney injuryLiver Disease scoreOutcomes of patientsPost-LT survivalPerioperative dialysisRenal recoveryKidney injuryLiver transplantOrgan failureLiver diseaseMedian timeMedian MELDACLFSimilar survivalDisease experienceDisease scorePatients
2018
NACSELD acute‐on‐chronic liver failure (NACSELD‐ACLF) score predicts 30‐day survival in hospitalized patients with cirrhosis
O'Leary JG, Reddy KR, Garcia‐Tsao G, Biggins SW, Wong F, Fallon MB, Subramanian RM, Kamath PS, Thuluvath P, Vargas HE, Maliakkal B, Tandon P, Lai J, Thacker LR, Bajaj JS. NACSELD acute‐on‐chronic liver failure (NACSELD‐ACLF) score predicts 30‐day survival in hospitalized patients with cirrhosis. Hepatology 2018, 67: 2367-2374. PMID: 29315693, DOI: 10.1002/hep.29773.Peer-Reviewed Original ResearchConceptsEnd-stage liver disease (MELD) scoreLiver Disease scoreOrgan failureHospitalized patientsBedside toolDisease scoreChronic liver failure scoreTertiary-care hepatology centersWhite blood cell countAlcohol-induced cirrhosisExtrahepatic organ failureMedian Child scoreReliable bedside toolChronic liver failureDiagnosis of cirrhosisBlood cell countRisk of mortalityPresence of infectionSimple bedside toolNorth American ConsortiumHepatology centersNACSELD-ACLFSeparate multicenterUninfected patientsProspective cohort
2017
Acute Kidney Injury in Cirrhosis: Baseline Serum Creatinine Predicts Patient Outcomes
Wong F, O'Leary J, Reddy K, Garcia-Tsao G, Fallon M, Biggins S, Subramanian R, Thuluvath P, Kamath P, Patton H, Maliakkal B, Tandon P, Vargas H, Thacker L, Bajaj J. Acute Kidney Injury in Cirrhosis: Baseline Serum Creatinine Predicts Patient Outcomes. The American Journal Of Gastroenterology 2017, 112: 1103. PMID: 28440305, DOI: 10.1038/ajg.2017.122.Peer-Reviewed Original ResearchConceptsAcute kidney injuryBaseline serum creatinineHigher baseline serum creatinineInternational Ascites ClubSerum creatinineDelta serum creatinineAKI outcomesKidney injuryPatient outcomesDevelopment of AKIIncidence of AKIStage 1 acute kidney injuryTertiary-care hepatology centersEnd-stage liver diseaseBaseline SCr levelPeak serum creatinineMultivariate logistic regressionNorth American ConsortiumAKI episodesAKI progressionAKI riskCirrhotic inpatientsHepatology centersCirrhotic patientsSCr levels
2016
A Karnofsky performance status–based score predicts death after hospital discharge in patients with cirrhosis
Tandon P, Reddy KR, O'Leary JG, Garcia‐Tsao G, Abraldes JG, Wong F, Biggins SW, Maliakkal B, Fallon MB, Subramanian RM, Thuluvath P, Kamath PS, Thacker LR, Bajaj JS, Disease N. A Karnofsky performance status–based score predicts death after hospital discharge in patients with cirrhosis. Hepatology 2016, 65: 217-224. PMID: 27775842, DOI: 10.1002/hep.28900.Peer-Reviewed Original ResearchConceptsKarnofsky performance statusPerformance statusMELD scoreCirrhosis patientsEnd-stage liver disease (MELD) scoreHigher white blood cell countTertiary-care hepatology centersEnd-stage liver diseaseWhite blood cell countPalliative management strategiesUse prognostic modelLiver Disease scoreMiddle-aged patientsMonths of dischargeLow performance statusIdentification of patientsHigh performance statusBlood cell countNorth American ConsortiumPerformance status groupsHepatology centersPostdischarge mortalityHospital dischargeHepatic encephalopathyIndependent predictorsThe 3‐month readmission rate remains unacceptably high in a large North American cohort of patients with cirrhosis
Bajaj JS, Reddy KR, Tandon P, Wong F, Kamath PS, Garcia‐Tsao G, Maliakkal B, Biggins SW, Thuluvath PJ, Fallon MB, Subramanian RM, Vargas H, Thacker LR, O'Leary JG, Disease N. The 3‐month readmission rate remains unacceptably high in a large North American cohort of patients with cirrhosis. Hepatology 2016, 64: 200-208. PMID: 26690389, PMCID: PMC4700508, DOI: 10.1002/hep.28414.Peer-Reviewed Original ResearchConceptsEnd-stage liver diseaseNosocomial infectionsLiver diseaseEnd-stage Liver Disease cohortEnd-stage liver disease (MELD) scoreSmall single-center studiesLarge North American cohortHigher readmission riskInfection-related readmissionLiver disease cohortPercent of readmissionsLiver Disease scoreSingle-center studyMultivariable logistic regressionNorth American cohortNorth American ConsortiumIndex admissionNonelective indicationsAdvanced cirrhosisProphylactic antibioticsCirrhosis severityInhibitor useReadmission ratesMonths postdischargeReadmission risk
2015
High risk of delisting or death in liver transplant candidates following infections: Results from the North American consortium for the study of end‐stage liver disease
Reddy KR, O'Leary JG, Kamath PS, Fallon MB, Biggins SW, Wong F, Patton HM, Garcia‐Tsao G, Subramanian RM, Thacker LR, Bajaj JS, Disease F. High risk of delisting or death in liver transplant candidates following infections: Results from the North American consortium for the study of end‐stage liver disease. Liver Transplantation 2015, 21: 881-888. PMID: 25845966, DOI: 10.1002/lt.24139.Peer-Reviewed Original ResearchConceptsEnd-stage liver diseaseLiver transplantationOrgan failureNorth American ConsortiumLiver diseaseUnderwent transplantationMELD scoreMedian ageEnd-stage liver disease (MELD) scoreTertiary-care hepatology centersAmerican ConsortiumExtrahepatic organ failureMean MELD scoreLiver Disease scoreLiver transplant candidatesPatients' median ageHepatitis C virusType of infectionPrevention of infectionHepatology centersTransplant candidatesCirculatory failureC virusInfected patientsHigh risk
2014
Survival in infection‐related acute‐on‐chronic liver failure is defined by extrahepatic organ failures
Bajaj JS, O'Leary JG, Reddy KR, Wong F, Biggins SW, Patton H, Fallon MB, Garcia‐Tsao G, Maliakkal B, Malik R, Subramanian RM, Thacker LR, Kamath PS, Disease T. Survival in infection‐related acute‐on‐chronic liver failure is defined by extrahepatic organ failures. Hepatology 2014, 60: 250-256. PMID: 24677131, PMCID: PMC4077926, DOI: 10.1002/hep.27077.Peer-Reviewed Original ResearchConceptsMean arterial pressureLower mean arterial pressureExtrahepatic organ failureChronic liver failureSpontaneous bacterial peritonitisUrinary tract infectionOrgan failureCirrhosis patientsHepatic encephalopathyIndependent predictorsLiver failureSecond infectionEndstage Liver Disease (MELD) scoreHigher white blood countBaseline independent predictorsDevelopment of ACLFNon-SBP infectionsLiver Disease scoreMore organ failuresWhite blood countNorth American ConsortiumDeterminants of survivalRenal replacementTract infectionsArterial pressure